替吉奥联合三维适形放射治疗中晚期食管癌的临床观察

Clinical Observation of Tegafur Combined with Three Dimensional Conformal Radiotherapy for Advanced Esophageal Carcinoma

目的:观察替吉奥联合三维适形放射治疗中晚期食管癌的临床疗效及安全性。方法:选取2013年8月-2016年3月许昌市中心医院收治的中晚期食管癌患者88例,按随机数字表法分为对照组和观察组,各44例。两组患者在抗炎、平喘等对症治疗的基础上,行三维适形放射治疗。对组患者给予氟尿嘧啶80 mg/m^2,ivgtt,d1+奈达铂70 mg/m^2,ivgtt,d1~d5;观察组患者给予替吉奥胶囊60 mg,bid,连用5 d,休息2 d。3周为1个疗程,共治疗3个疗程。观察两组患者临床疗效及治疗前后血清炎症因子[肿瘤坏死因子α(TNF-α)、白细胞介素(IL)-6、IL-8]、实验室检查指标[血管内皮生长因子(VEGF)、糖类抗原(CA)125、CA199、癌胚抗原(CEA)]和生存质量测定表(QLQ-C30)评分,记录两组患者不良反应发生情况。结果:观察组患者总有效率为88.64%,显著高于对照组的68.18%,差异有统计学意义(P<0.05)。治疗前,两组患者血清炎症因子水平、实验室检查指标水平和QLQ-C30评分比较,差异均无统计学意义(P>0.05);治疗后,两组患者血清炎症因子和实验室检查指标水平显著降低,QLQ-C30评分显著升高,且观察组显著优于对照组,差异均有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:替吉奥联合三维适形放射治疗中晚期食管癌疗效较好,能明显降低患者血清炎症因子和相关实验室检查指标水平,提高患者生存质量,且不增加不良反应。

OBJECTIVE： To observe clinical efficacy and safety of tegafur combined with three dimensional conformal radiotherapy for advanced esophageal carcinoma. METHODS： Totally 88 cases of advanced esophageal carcinoma admitted into Xuchang central hospital during Aug. 2013-Mar. 2016 were selected and divided into control group and observation group according to random number table, with 44 cases in each group. On the basis of anti-inflammatory, relieving asthma and other symptomatic treatment, two groups accepted three dimensional conformal radiotherapy. Control group was given fluorouracil 80 mg/m2,ivgtt,d1＋nadeplatin 70 mg/m2,ivgtt,d1-d5. Observation group was given Tegafur capsules 60 mg,bid, continuous use 5 days, rest for 2 days. A treatment course lasted for 3 weeks, and they received 3 courses of treatment. Clinical efficacies of 2 groups were observed as well as serum inflammatory factors （TNF-α, IL-6, IL-8）, lab indexes （VEGF, CA125, CA199, CEA）, QLQ-C30 scores before and after treatment. The occurrence of ADR was recorded in 2 groups. RESULTS： The total response rate of observation group was 88.64%, which was significantly higher than 68.18%, with statistical significance （P〈0.05）. Before treatment, there was no statistical significance in serum inflammatory factor levels, lab index levels and QLQ-C30 scores between 2 groups （P〉0.05）. After treatment, serum inflammatory factor levels and lab index levels of 2 groups were significantly decreased, while QLQ-C30 scores were decreased significantly; the observation group was significantly better than control group, with statistical significance （P〈0.05）. There was no statistical significance in the incidence of ADR between 2 groups （P〉0.05）. CONCLUSIONS： Tegafur combined with three dimensional conformal radiotherapy shows good therapeutic efficacy for advanced esophageal carcinoma, can significantly reduce serum inflammatory factor levels and lab index levels and improve life quality but do not increase the occurrence of ADR.